Mylan’s five-year-old practice of selling the allergic reaction treatment EpiPen in two-packs has largely remained a minor point in the saga of price increases, public outrage, lawmaker scrutiny and now lawsuits.

But the product’s availability in only a bundled package of two auto-injectors, long a point of contention, has also served to exacerbate Mylan’s
MYL, -1.11%
sixfold price increase for consumers.

That’s the focus of a new class action lawsuit, which claims that the two-pack sale of EpiPens is “a pretense for charging unconscionable prices” and that Mylan is “misstating the science of EpiPen dosage in order to purportedly justify its price gouging,” in violation of various state deceptive and unfair trade practice and consumer protection laws.

Mylan’s practice of selling the EpiPen exclusively in two-packs dates back to 2011. Even the $300 generic EpiPen, which Mylan announced after facing public backlash over its price increases, will be sold in a two-pack.

The company explained the move as a response to then-new government guidelines, which recommended doctors prescribe two doses of the treatment epinephrine for those at risk of or who have experienced the life-threatening allergic reaction anaphylaxis.

But the lawsuit says that Mylan wasn’t following government guidelines by requiring prescription and purchase of two-packs rather than relying on doctors’ medical judgment.

Doctors could still prescribe more than one EpiPen if the product was sold individually as well as in two-packs, especially since “only a small percentage” of patients need a second dose, the lawsuit said.

Two-packs force patients to buy multiple EpiPens even when trying to replace just one, it said.

It’s true that several other medical conditions, including asthma, are also eligible for an EpiPen or auto-injector prescription but aren’t recommended to have two doses of the product on hand.

The two-pack “prices a lot of families out of this market,” says Robyn O’Brien, an author and founder of Allergy Kids, a nonprofit resource for parents.

She and others say the EpiPen is poorly designed, resulting in accidental injections and facilitating a need for more of the product.

“Does everybody need to have a two-pack? Or is it a function of the accidental injections and non-intuitive design?” she asked.

But some people say they prefer to have two auto-injectors in case one is damaged or something else goes wrong, especially since epinephrine is sensitive to temperature changes.

But the sale of single EpiPens still occurs outside of the U.S., which “shows that Mylan was improperly taking advantage of U.S. patients. If patient safety was the paramount concern, then Mylan would have stopped production of single EpiPens worldwide,” the lawsuit said.

The suit is seeking to prevent Mylan selling only EpiPen two-packs and charging “unconscionable” prices.

The lawsuit, filed in Michigan in late August, also claimed that some of the advisers influencing the 2010 government guidelines had received payment from Mylan in the past.

Mylan did not respond to a request for comment.

The Michigan lawsuit is one of two legal approaches that have so far been used to target Mylan over the EpiPen price increases, noted Tom Rohback, a litigator with Axinn Veltrop & Harkrider.

Another lawsuit, filed in Ohio, along with an investigation by the New York Attorney General’s office have instead looked at whether Mylan violated antitrust law.

Rohback said the suit “could have legs,” though he doesn’t believe it focuses on “the heart of the real problem, the way the price has gone up.” Thus, remedies — such as requiring Mylan to sell only one EpiPen — might not address the price increase issue at all, he said.

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